本文選題：膽道手術(shù)　切入點(diǎn)：T型管　出處：《吉林大學(xué)》2015年碩士論文

【摘要】：目的 探討在膽道手術(shù)中采用新型雙腔T型膽汁回輸引流管與普通T型管在預(yù)防患者術(shù)后并發(fā)癥及患者術(shù)后恢復(fù)情況發(fā)生的作用，通過對兩種T型管應(yīng)用的回顧性分析，選擇一種更合理的T管引流方式。 方法 選取2013年6月至2015年2月于吉林大學(xué)中日聯(lián)誼醫(yī)院新民院區(qū)肝膽胰外科54例行膽道手術(shù)留置T型管患者的臨床資料進(jìn)行回顧性研究與分析。我們將54例患者隨機(jī)分為A、B組，每組患者均采取常規(guī)開腹膽道手術(shù)，A組（n=27）患者為觀察組，術(shù)中留置新型雙腔T型膽汁回輸引流管；B組（n=27）患者為對照組，術(shù)中留置常規(guī)T型管。記錄兩組患者術(shù)后白細(xì)胞（WBC）、白蛋白（ALB）、總膽紅素（TBIL）等恢復(fù)正常時(shí)間及術(shù)后膽汁丟失量情況、術(shù)后補(bǔ)液總量、患者術(shù)后住院天數(shù)和住院總費(fèi)用、術(shù)后出現(xiàn)并發(fā)癥、術(shù)后拔除T型管時(shí)間以及術(shù)后殘余結(jié)石例數(shù)等情況。 結(jié)果 選取的54行膽道探查術(shù)的患者納入本項(xiàng)研究范圍，兩組（A、B)各27名患者，其中A組26例患者膽汁回輸管在十二指腸內(nèi)，1例患者膽汁回輸管在膽總管內(nèi)視為失敗，不納入該組數(shù)據(jù)統(tǒng)計(jì)。觀察組術(shù)后白細(xì)胞（WBC）、白蛋白（ALB）、總膽紅素（TBIL）等恢復(fù)正常時(shí)間各項(xiàng)觀察指標(biāo)均優(yōu)于對照組(P＜0．05)，具有統(tǒng)計(jì)學(xué)意義。兩組患者術(shù)后T管拔除時(shí)間對比(P0．05)，不具有統(tǒng)計(jì)學(xué)意義。兩組患者均治愈，無死亡病例。觀察組術(shù)后并發(fā)癥發(fā)生率為23．3%對照組為65.4%，觀察組術(shù)后并發(fā)癥發(fā)生率遠(yuǎn)低于對照組術(shù)后并發(fā)癥發(fā)生率，，兩組差異有統(tǒng)計(jì)學(xué)意義(P＜0．05或P0.01）。 結(jié)論 在膽道手術(shù)中采用新型雙腔T型膽汁回輸引流管在預(yù)防患者術(shù)后并發(fā)癥（切口感染、肺部感染、腹腔感染、出血、膽汁漏）及患者術(shù)后恢復(fù)情況，并利于患者術(shù)后早期腸內(nèi)營養(yǎng)，恢復(fù)腸道功能較普通T型管有較大的優(yōu)勢。
[Abstract]:PurposeTo explore the role of new type T-type bile drainage tube and common T-tube in preventing postoperative complications and postoperative recovery in patients undergoing biliary tract operation. The application of the two types of T-tube was analyzed retrospectively.Choose a more reasonable T tube drainage method.MethodFrom June 2013 to February 2015, the clinical data of 54 patients with T-tube indwelling in the Department of Hepatobiliary and Pancreatic surgery in Xinmin Hospital of Jilin University were retrospectively studied and analyzed.54 patients were randomly divided into group A (n = 54), group A (n = 27), group A (n = 27), group B (n = 27) and group B (n = 27).The recovery time of WBC, Alb, TBIL, the amount of bile loss, the total amount of fluid rehydration, the days of hospitalization, the total cost of hospitalization, the complications after operation were recorded in the two groups.The time of removing T-tube and the cases of residual stone after operation were analyzed.ResultA total of 54 patients with biliary tract exploration were included in this study, 27 patients in each group were treated as a failure in group A, 26 patients in group A were treated as a failure in the common bile duct, 1 patient with bile duct in duodenum, 1 patient with bile duct in duodenum.Not included in the group of data statistics.The indexes of WBC, Alb, TBIL in the observation group were better than those in the control group (P < 0.05), and there was significant difference between the observation group and the control group (P < 0.05).The patients in both groups were cured and there were no death cases.The incidence of postoperative complications in the observation group was 23.3% in the control group and 65.4% in the control group. The incidence of postoperative complications in the observation group was significantly lower than that in the control group (P < 0.05 or P 0.01).ConclusionTo prevent postoperative complications (incision infection, pulmonary infection, intraperitoneal infection, hemorrhage, bile leakage) and postoperative recovery, a new type of double-lumen T-type bile drainage tube was used in biliary tract surgery to prevent postoperative complications (incision infection, pulmonary infection, abdominal infection, hemorrhage, bile leakage).It is beneficial to early postoperative enteral nutrition and recovery of intestinal function than that of T-tube.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R657.4

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